THEME: Medical - Healthcare Matters

Medicine is a subject that requires the practitioner to have a passion to heal the sick and save lives. Historically, doctors take the Hippocratic oath to uphold their calling and high ethical standards.

Many of our local students aspire to study medicine because of its noble calling but there are very high bars for entry into our local medical schools and medical schools admit students based on their stellar academic results and not so much on their disposition to practice medicine. 

Each year, our intake of medical students is less than 300 and this is hardly enough to meet increasing demands. A great number of our students with the right aptitude for medicine are forced to leave for overseas medical schools, spending huge sums of money to earn their medical degrees. Yet, instead of expanding the local intake, foreigners are recruited to make up the numbers. This scene is repeated in the nursing line which has become heavily reliant on foreign nurses (Click HERE).

There is a need to seriously review our policies and to expand our intake of medical students to allow more of our own students with the right aptitude but less stellar academic results to train and become medical practitioners. From a social perspective, the more doctors and nurses there are, the more our aged and sick will have ready access to medical attention. An increase in the supply of doctors and nurses, and medical practitioners in specialisations that are in growing demand, will go towards lowering overall medical costs and waiting time.

Government polyclinics in Singapore fulfill the primary healthcare role. These are managed by the National Healthcare Group and Singapore Healthcare Services which were formed in 2000 (Click HERE). They provide subsidised outpatient medical care, health screening and pharmacy services. However, the percentage of government polyclinics vis-a-vis private clinics stands at only 20%. This is certainly less than ideal.

Currently, government polyclinics open only from 8 a.m. to 4 p.m. and are closed on Sundays and Public Holidays. It is perhaps time to look at operating government polyclinics on a 24/7 basis to cater to the needs of an expanding ageing population to help bring down the costs of healthcare. Consultations at polyclinics should be free for all elderly citizens above 65 years old and for those younger, the consultation fee could be fixed as low as possible. Drugs for coughs and colds and other common ailments should be provided free.

Prevention is better than cure and steps should be taken to provide early detection and treatment of diseases. However, breast screenings, pap smears and other health screenings are getting more and more costly and they deter people from going for their yearly check-ups. There can be a national health screening programme which charges a nominal fee for our citizens to encourage them to take care of their own health. Early treatments will also be less costly and increase the chances of full recovery. As it is often said that our people are the only natural resource that we have, it is surely worth the investment to ensure that they are healthy and strong.

The Community Health Assist Scheme (CHAS) provides subsidies for citizens from lower- and middle-income households for medical and dental care in participating clinics. Presently, applicants are means-tested by taking their total household income divided by the total number of family members living together. The calculated income must not exceed $1,800. This income ceiling should be raised to reflect the rising costs of living. Further, the criteria for those without income to not possess a home with an annual value of not more than $21,000 should be reviewed along with any increase in annual values.

There are also caps on the subsidies for Blue, Orange and Pioneer Generation CHAS cardholders pertaining to chronic conditions. Whilst the caps ($360 and $540 for simple and complex conditions as defined) are published, it would be useful if the balance of the cap remaining provided to the cardholder after every deduction. These cards are currently valid for one year periods and cardholders must apply for renewal. One suggestion is to provide for automatic renewal to save trouble for these cardholders who are generally old and illiterate. 

Rising medical costs have led to various healthcare policies like the Pioneer Generation Package ("PGP") for elderly folks, whose need for financial assistance to reduce their medical costs was neglected for quite a long time. It is estimated that 450,000 Singaporeans, whom the government identifies as the pioneer generation, will benefit. 

Although this is a rather artificial categorization and has led to unhappiness from those who miss the cut-off age, the PGP package serves to help a group of elderly Singaporeans who are 65 and above w.e.f. 31 December 2014. Since the idea behind this package is to show appreciation for their contributions, the PGP ought to cover all their medical costs of the "pioneers" without requiring any of them to make any balance payment.

Decision to not contest in Potong Pasir SMC

Last night, I was doing my usual walkabout. As I was driving out from the carpark near Block 108 in Potong Pasir after 11 p.m., I saw a Mercedez Benz waiting to park. It has just entered the car park and its headlights were shining in my direction.

As I exited from my parking lot and passed by the Merc to my right, I noticed the lady driver struggling to turn her steering wheel so as to move her car aside to let me pass. As I drove passed the stationary Merc, I saw that the driver was Mrs. Lina Chiam. She was in her party T-shirt and looked rather haggard.

Along the way home, I kept thinking about my encounter with Mrs. Chiam and felt sorry that she was still out at such a late hour. I recall her recent statement about this election being her last election and that she will be retiring with Mr. Chiam. I began to have this feeling of sadness and couldn't sleep after reaching home.

I contacted my team members this morning and shared with them my thoughts and feelings. And I told them my decision. I have decided not to contest. Instead, I will lead my team to show our support for Mrs. Chiam at her rally and hope she succeeds to regain Potong Pasir SMC and continue Mr. Chiam's dedicated service to its residents.

The 3-cornered fight in Potong Pasir SMC that was meant to be will no longer take place. I am sorry to disappoint all those who have encouraged me to offer my candidacy and to serve the residents of Potong Pasir SMC as their Member of Parliament. In my walkabouts over the last 2 months, I have come to know many of you at a personal level and appreciate your warm support. Let me assure you that notwithstanding this decision, I will continue to be at your service. For Potong Pasir SMC will always be my kind of town.

Peolitics Model of Politics

Current Political Ideology

The current dominant political thinking in Singapore is an economy-centred ideology. This ideology is based on the government's "Singapore Inc."  model which places economic interests at the heart of government policy-making. The result is the Singapore that we have created today. A country that has achieved economic success at high social costs with over-population, intense competition for jobs, housing and transport, runaway costs of living, stressful lifestyle and a severe income gap.

National policies which place the economy at their core without counting the social costs can only make the rich richer and will never lead the ordinary citizens to attain the first goal of our national pledge - happiness. Our experience in the last 25 years tells us what we need to know. The way forward in the next 25 years depends on a change of mindset. We need to build a people and not just an economy. In order to do that, national policies must be centred on the people’s welfare and aspirations. Lest it be mistaken, we are not talking about welfarism. We are talking about not building an economy at the expense of the people’s welfare and nation-building.

People-Centred Political Ideology

Politics is about people. People-centred political ideology (“Peolitics”) is premised on the principle that the people’s welfare and aspirations are paramount in national policies. In order for the leaders and their people to achieve unity of purpose, the Peolitics model emphasizes the importance of a Sensitive and Responsive Leadership and a People with a Political Conscience and Responsibility.

Leadership

Leaders must deploy their five (5) senses to understand the needs and wants of the people. A good leader must be adept at all the following:

1. See what’s been happening;
2. Listen to the noises in the voices;
3. Sniff out the real problems;
4. Taste the lives of ordinary folks; and
5. Touch base with the ground always;

People

Just as the leadership has political responsibilities, the people must also do their part to help create a positive political culture. The people must motivate their leaders to do their best to meet their needs and wants by behaving:

1. Rationally;
2. Reasonably; and
3. Responsibly.

Political Conscience and Responsibility

Every decent human being has a conscience. This arises from one’s ingrained sense of values. We feel a sense of guilt when we do something that runs contrary to such values. Hence, Political Conscience refers to the national values that are ingrained in our people. These national values are encapsulated in our pledge:

"We, the people of Singapore, pledge ourselves as one united people, regardless of race, language or religion, to build a democratic society, based on justice and equality, so as to achieve happiness, prosperity and progress for our nation.”

The Political Responsibility of the people is premised on their Political Conscience. The values that we pledge shall guide the people in the discharge of their political responsibility. This responsibility is particularly important for democracy to succeed. It has often been said that democracy is the rule of the majority and the minority may feel threatened by the “tyranny of the majority”. This scenario may be pre-empted if all people in a democracy are guided by their political conscience to discharge their political responsibility in a manner that does not betray their national values as one people. Only then can we achieve a positive political culture.

Positive Political Culture 

Politics in Singapore is becoming radicalized as we witness more and more social agencies being used for political ends and grassroots leaders engaging in partisan politics. Such a development is unhealthy and will lead to repugnance for politics and politicians. The social contract between the state and the people has to be premised on a relationship of trust and respect. In order to sustain that relationship, it is important to build a political culture that not only encourages people to engage constructively in political discourse without fear of victimization but further motivates those with the necessary talents that we need to spontaneously offer their services to the people and the nation.